Squamous cell carcinoma (SCC) of the bladder is a relatively uncommon cause of bladder cancer accounting for <5% of bladder tumors in the western countries. SCC has a slight male predominance and tends to occur in the seventh decade of life. The main presenting symptom of SCC is hematuria, and development of this tumor in the western world is associated most closely with chronic indwelling catheters and spinal cord injuries. A 39-year-old Caucasian female presented with bladder and lower abdominal pain, urinary frequency, and nocturia which was originally believed to be interstitial cystitis (IC) but was later diagnosed as SCC of the bladder. Presentation of SCC without hematuria is an uncommon presentation, but the absence of this symptom should not lead a practitioner to exclude the diagnosis of SCC. This case is being reported in an attempt to explain the delay and difficulty of diagnosis. Background on the risk factors for SCC of the bladder and the typical presenting symptoms of bladder SCC and IC are also reviewed.
On unadjusted logistic regression, men were more likely to earn >$350K (OR[2.01, p[0.02). However, on multivariable regression gender was no longer significant (OR[1.59 p[0.11) after adjusting for covariates. Factors associated with higher odds of earning >$350K include: more clinical hours, fewer non-clinical hours, shorter mean office visits, more office visits, more inpatient surgical procedures, private practice setting, subspecialty training, practicing in the Northeast and non-white race (Table 1). Sex, urban practice setting, age, and Hispanic ethnicity were not associated with salary in the adjusted model.CONCLUSIONS: This analysis suggests a gender pay gap in urology which appears to be mediated by a number of factors. While men and women work equal numbers of hours, women urologists are appear to be more likely to work in less profitable settings, performing fewer inpatient procedures and seeing fewer patients. Future research should seek to understand whether women choose these practice characteristics or whether external factors compel them to do so.
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